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Topic:Prognosis
Prognosis in horses refers to the prediction of the likely outcome or course of a disease or injury in equine patients. It involves assessing various factors such as the nature and severity of the condition, the horse's overall health, and response to treatment. Prognostic evaluations help veterinarians and horse owners make informed decisions regarding treatment options, management strategies, and potential recovery. The process often incorporates clinical assessments, diagnostic tools, and historical data to estimate the chances of recovery or progression. This page compiles peer-reviewed research studies and scholarly articles that explore methodologies, factors influencing prognostic outcomes, and the implications of prognostic evaluations in equine veterinary practice.
Short-term outcome and risk factors for post-operative complications following umbilical resection in 82 foals (2004-2016). Umbilical remnant infection and patent urachus are an important cause of morbidity for the equine neonate. Left untreated, fatal complications can develop. Identifying risk factors for post-operative complications after surgery are important for estimating prognosis. Objective: To identify risk factors associated with post-operative complications in foals undergoing umbilical remnant resection due to patent and/or infected umbilical remnants. Methods: Retrospective case series. Methods: Foals undergoing umbilical remnant resection due to patent urachus or infected remnants at the Marion duPont...
Surgical management of postcastration spermatic cord stump infection in horses: A retrospective study of 23 cases. To report the surgical management and the short- and long-term follow-up of postcastration spermatic cord infection in horses. Methods: Retrospective case series. Methods: Twenty-three client-owned horses. Methods: Medical records (2001-2017) of horses that had been surgically treated for spermatic cord stump infection after castration were reviewed. Time from castration to presentation, diagnostic procedures, surgical complications, bacterial culture and ancillary testing, and survival to discharge were collected. Long-term follow-up was obtained by owner survey when possible. Descriptive sta...
Conservative versus surgical treatment of 21 sports horses with osseous trauma in the proximal phalangeal sagittal groove diagnosed by low-field MRI. To compare the outcome following conservative vs surgical management of sports horses with a diagnosis of subchondral bone trauma of the proximal aspect of the proximal phalanx (PP) by low-field MRI. Methods: Retrospective case series. Methods: Twenty-one mature sports horses with evidence of high water signal within the proximal sagittal groove of the PP according to low-field MRI of the fetlock, with no definitive radiographic evidence of fracture. Methods: Medical records (2010-2017) of horses admitted to 2 referral hospitals were reviewed. Historical, clinical, radiographic, and MRI findin...
Horses with solar foot penetration, deep digital flexor tendon injury, and absence of concurrent synovial sepsis can have a positive outcome. Solar foot penetration is one of the causes of deep digital flexor tendon injuries in horses, however, limited information is available on the prognosis for return to soundness in the absence of synovial sepsis. Objectives of this retrospective observational study were to describe low-field magnetic resonance imaging (MRI) findings and long-term outcome for a group of horses with this combination of clinical problems. Horses were included if low-field standing MRI of the foot was performed following puncture wounds, injury of the deep digital flexor tendon was diagnosed, and sepsis was confirm...
Cardiac/Cardiovascular Conditions Affecting Sport Horses. Cardiac murmurs are not uncommonly detected in the equine athlete. Although most are benign in nature, differentiation and quantification of murmurs due to valvular regurgitation are important for prognosis and recommendations. Arrhythmias can be associated with structural disease or occur independently and may range in severity from minimal clinical effect to poor performance to presenting a safety risk to rider and horse. This article discusses commonly encountered cardiac conditions in the sport horse. Physical examination, diagnostic approach, valvular disease, and arrhythmias with an impa...
Using quarterly earnings to assess racing performance in 66 thoroughbreds after transendoscopic laser surgery for treatment of epiglottic entrapment. To assess the outcome of transendoscopic laser surgery for the treatment of epiglottic entrapment (EE) and determine the influence of preoperative morphological characteristics on outcomes. Methods: Retrospective cohort study. Methods: Thoroughbred racehorses treated with transendoscopic laser surgery (n = 66) and untreated cohorts (n = 132). Methods: Medical, surgical, and race records of 66 horses treated with transendoscopic laser surgery were compared with untreated cohorts randomly selected from their last race presurgery. Postsurgery data were collated as number of starts and rac...
Neck, Back, and Pelvic Pain in Sport Horses. Pain localized to the neck, back, and or pelvis can result in a profound effect on the horse's performance. These conditions can present with a varied and nonspecific set of clinical signs. A careful and thorough examination of these areas by means of physical examination, lameness evaluation both in hand and under saddle, diagnostic anesthesia, and the use of multiple imaging modalities in combination is often necessary to have an accurate prognosis. Medical and surgical management where appropriate of the conditions highlighted in this article are discussed as well as their individual progno...
Upper Airway Conditions Affecting the Equine Athlete. Many abnormalities of the upper airway that can inhibit performance are determined on a critical resting endoscopic evaluation. Some dynamic abnormalities can only be seen during an exercising endoscopic evaluation, which should be performed whenever the history of abnormal noise or performance limitations is not completely consistent with the resting endoscopic findings. Head and neck position may play a critical role in the evaluation process and the exact position during performance should be reproduced during the clinical examination to definitively define the abnormality. Treatments and p...
Recent advances in conservative and surgical treatment options of common equine foot problems. Foot problems are very common causes of lameness in horses. With the recent diagnostic advances to evaluate and treat foot pathology as well as to monitor response to therapy, it is now possible to more accurately evaluate the effectiveness of many of these treatments. This review details some of the recent advances of the most common conservative and surgical treatment options for foot problems in horses, including an overview of evidence on the efficacy to support the use of these treatment options and on factors that may affect prognosis.
Paranasal sinus cysts in the horse: Complications related to their presence and surgical treatment in 37 cases. Paranasal sinus cysts (PSC) are a common cause of equine secondary sinusitis. The outcome and associated complications have not been frequently reported. Objective: To review the associated clinical signs, associated morbidities and outcomes of horses treated for PSC. Methods: Retrospective multicentre case series. Methods: Retrospective analysis of case records and telephone follow up survey. Results: Subjects were 37 horses 1-24 years old that were presented with nasal discharge (n = 31), facial swelling (n = 25) and epiphora (n = 19). Radiography and computed tomography allowed identificati...
Insulin dysregulation in horses with systemic inflammatory response syndrome. Systemic inflammation is a cause of insulin dysregulation in many species, but the insulin and glucose dynamics in adult horses diagnosed with systemic inflammatory response syndrome (SIRS) are poorly documented. Objective: In SIRS in horses, insulin and glucose dynamics will be altered and associated with survival. Methods: Adult horses diagnosed with SIRS admitted to a referral hospital. Methods: Prospective study enrolling horses diagnosed with SIRS in which serum insulin and glucose concentrations were measured. Horses were grouped by outcome (survival, hyperinsulinemia, and hyperglycemia)...
[Thrombocytopenia in horses]. The retrospective study aimed to evaluate the prevalence of true thrombocytopenia and ethylenediaminetetraacetic acid (EDTA)-induced pseudothrombocytopenia in horses and ponies and to assess the diagnostic and prognostic utility of true thrombocytopenia. Methods: In 3592 patients (2008-2015) hematological data (ADVIA® 2120, Siemens) were reviewed. Inclusion criteria were platelet counts < 90 x 109/l (EDTA-blood) and/or < 84 x 109/l (citrate blood). Thrombocytopenia was classified as true, EDTA-induced, and questionable. Patients with true thrombocytopenia were assigned to nine groups ac...
Clinical findings and prognosis of interference injuries to the palmar aspect of the forelimbs in Standardbred racehorses: A study on 74 cases. Information on interference injuries in racehorses is lacking. Objective: To describe clinical findings and prognosis of palmar forelimb interference injuries in Standardbreds. Methods: Retrospective cohort study. Methods: Records of 74 racehorses sustaining palmar forelimb interference injuries were studied; 7 occurred during training and 67 during racing. The number of starts before injury, hind shoeing status, gait penalties and racing speeds in cases occurring during racing were compared with negative controls (67 age, sex and speed category matched horses) from the same races. The number ...
Clinical outcomes after colopexy through left ventral paramedian incision in 156 thoroughbred broodmares with large colon disorders (1999-2015). To describe a technique for colopexy via a left ventral paramedian incision and report postoperative clinical outcomes. Methods: Retrospective case series. Methods: One hundred fifty-six thoroughbred broodmares treated with a colopexy through a left ventral paramedian incision between 1999 and 2015. Methods: Medical records were reviewed for postoperative complications and survival to discharge. The survival rate at 1 year after surgery was based on the medical record, progeny record, or client telephone conversation. Progeny records were reviewed to assess reproductive performance. T tests, Ï...
Equine idiopathic hemorrhagic cystitis: Clinical features and comparison with bladder neoplasia. A new syndrome of hematuria in horses has been documented. Objective: Hemorrhagic cystitis is a novel cause of stranguria and hematuria in horses. This syndrome may be difficult to differentiate from bladder neoplasia because they share several clinical features. Methods: Eleven horses with idiopathic hemorrhagic cystitis and 7 horses with bladder neoplasia. Methods: Retrospective cohort study. Results: Hemorrhagic cystitis was detected on cystoscopy of affected horses, with hemorrhagic and thickened apical bladder mucosa. Clinical signs and endoscopic appearance of the bladder resolved within...
Arthroscopic removal of osteochondral fragments in the dorsal pouch of the proximal intertarsal joint in 29 horses. To describe the radiographic and surgical findings of horses with osteochondral fragments (OCF) in the proximal intertarsal joint (PIJ) and to detail the technique for arthroscopic fragment retrieval and report outcomes. Methods: Retrospective case series. Methods: Twenty-nine horses (32 tarsi) with OCF in the PIJ. Methods: Medical records of horses with radiographic evidence of OCF in the PIJ were reviewed. Clinical features, number of fragments, location, arthroscopic appearance, and outcome were recorded. Technical modifications with visual aids specific to this arthroscopic technique are d...
Axial sesamoiditis in the horse: A review. Axial sesamoiditis or osteitis of the proximal sesamoid bones (PSBs) in the horse is described as a rare condition. The cause remains unknown and speculative, with vascular, infectious, and traumatic aetiologies implicated. It is specifically associated with injury of the palmar or plantar ligament (PL), also known as the intersesamoidean ligament. Imaging findings are generally rewarding and radiological changes are typical, if not pathognomonic, for the condition. Lesions consist of bone lysis at the apical to mid-body axial margins of the PSBs, with variable degrees of joint effusion. Radio...
Blood glucose is unlikely to be a prognostic biomarker in acute colitis with systemic inflammatory response syndrome in Thoroughbred racehorses. Although hyperglycemia at admission with colic has been reported to have a poor prognosis, there is no report specifically about acute colitis with systemic inflammatory response syndrome (SIRS) in horses. In this study, we measured blood glucose (Glu), insulin (Ins), and cortisol (Cor) levels in 17 Thoroughbred racehorses diagnosed as having acute colitis with SIRS, and examined the relationship between time-dependent changes in Glu, Ins, and Cor and prognosis. Glu levels were high in 3 horses at admission, but thereafter no horses had persistently high Glu levels. There was no significant di...
Clinical use of plasma lactate concentration. Part 2: Prognostic and diagnostic utility and the clinical management of hyperlactatemia. To review the current literature pertaining to the use of lactate as a prognostic indicator and therapeutic guide, the utility of measuring lactate concentrations in body fluids other than blood or plasma, and the clinical management of hyperlactatemia in dogs, cats, and horses. Methods: Articles were retrieved without date restrictions primarily via PubMed, Scopus, and CAB Abstracts as well as by manual selection. Unassigned: Increased plasma lactate concentrations are associated with increased morbidity and mortality. In populations with high mortality, hyperlactatemia is moderately predicti...
Ultrasonographic-based predictive factors influencing successful return to racing after superficial digital flexor tendon injuries in flat racehorses: A retrospective cohort study in 469 Thoroughbred racehorses in Hong Kong. Superficial digital flexor tendon (SDFT) injury is an important health and welfare concern in racehorses. It is generally diagnosed with ultrasonography, but predictive ultrasonographic features have not been reported. Objective: To determine ultrasonographic features of forelimb SDFT injury at initial presentation in Thoroughbred racehorses that could predict a successful return to racing (completing ≥5 races). Methods: Retrospective cohort study. Methods: Digitised ultrasonographic images of 469 horses with forelimb SDFT injuries from the Hong Kong Jockey Club (2003-2014) were evaluated, u...
Catheter-associated venous air embolism in hospitalized horses: 32 cases. Venous air embolism is a potentially life-threatening complication of IV catheter use in horses. Despite widespread anecdotal reports of their occurrence, few cases have been reported in the literature and the prognosis is currently unknown. Objective: Our objective was to describe the surrounding circumstances, clinical signs, treatment, progression, and outcome of venous air embolism in hospitalized horses. Methods: Thirty-two horses with acute onset of compatible clinical signs associated with IV catheter disconnection or damage. Methods: Multicenter retrospective study. Data extracted from...
Diagnostics and Treatments in Chronic Diarrhea and Weight Loss in Horses. Chronic diarrhea in the horse is defined as diarrhea present for more than several days with little if any improvement. The diagnosis and treatment of horses with chronic diarrhea usually present a great challenge to the clinician. There are many limitations to treatment of these patients given the limited numbers in which a final diagnosis can be achieved. The lack of knowledge of the alterations of horse microbiota during chronic diarrhea and the multiplicity of causes also make treatment challenging. A poor prognosis is often attached to chronic diarrhea, particularly in cases with neoplasi...
Tenotomy of the semitendinosus muscle under standing sedation versus general anesthesia: Outcomes in 20 horses with fibrotic myopathy. To compare outcomes after semitendinosus tenotomy performed under standing sedation versus general anesthesia. Methods: Retrospective case series. Methods: 20 horses with fibrotic myopathy of the semitendinosus muscle. Methods: Medical records (2002-2015) of horses undergoing tenotomy of the semitendinosus muscle for the treatment of fibrotic myopathy were reviewed. Signalment, history, affected muscles, restrain method, surgical procedures, and short-term outcome as well as complications were retrieved from records. Long-term outcome (gait and athletic function) was assessed at least 6 months...
Surgical repair of propagating condylar fractures of the third metacarpal/metatarsal bones with cortical screws placed in lag fashion in 26 racehorses (2007-2015). Despite the recommendation of plate fixation for propagating condylar fractures of the third metacarpal (McIII) or third metatarsal bone (MtIII), lag screw fixation can be a viable surgical option. Objective: To evaluate short-term outcome and long-term racing performance of horses that underwent lag screw fixation of long condylar fractures of the McIII/MtIII. Methods: Retrospective case series. Methods: Medical records, post-surgical racing performance and outcome of 26 horses with propagating fractures of the medial and/or lateral condyle of McIII/MtIII were reviewed. Medical information in...
Equine Dysautonomia. Equine dysautonomia (ED; also known as equine grass sickness) is a neurological disease of unknown cause, which primarily affects grazing adult horses. The clinical signs reflect degeneration of specific neuronal populations, predominantly within the autonomic and enteric nervous systems, with disease severity and prognosis determined by the extent of neuronal loss. This review is primarily focused on the major clinical decision-making processes in relation to ED, namely, (1) clinical diagnosis, (2) selection of appropriate ancillary diagnostic tests, (3) obtaining diagnostic confirmation, (4)...
Diagnosis, treatment and outcome of cranial nuchal bursitis in 30 horses. No large retrospective case series describing the treatment and outcomes following diagnosis of cranial nuchal bursitis have been published. Objective: To describe the clinical presentation, diagnostic techniques, treatment and outcome of horses suffering from cranial nuchal bursitis and to determine their outcome after medical or surgical treatment. Methods: Retrospective case series. Methods: Medical records (1990-2014) of two referral centres were reviewed for signalment, diagnostic features, method of treatment (medical, surgical or both) and outcome. Results: The median age of horses was ...
Factors affecting the prognosis for uterine torsion: the effect of treatment based on measurements of serum progesterone and estradiol concentrations after surgery. This is a retrospective study of uterine torsion (UT) in seven mares. In two cases, serum progesterone and estradiol concentrations were also investigated. The mare and foal/fetus survival rate was 57% (4/7). Four cases presented with clockwise torsion, and two cases presented with counterclockwise torsion. The direction was undetermined in one case. The degree of torsion varied. Correction of torsion was performed by ventral midline celiotomy in all cases. In the two cases with measured hormone levels, elevated levels of P were decreased through medication. All mares discharged from the hospi...
Protein biomarker of cell proliferation determines survival to discharge in cases of equine large colon volvulus. Progenitor cells play critical roles in epithelial repair following ischaemic injury. Protein biomarkers have been used to identify intestinal progenitor cell subpopulations. This study aims to determine if a critical number of intestinal progenitor cells can predict tissue viability and survival to discharge of large colon volvulus (LCV) cases. Objective: The objectives were to 1) identify intestinal progenitor cell subpopulations using biomarkers: proliferating cell nuclear antigen (PCNA), sex determining region Y box 9 (SOX9), phospho-histone H3 (PHH3) and Ki-67, 2) define cut-off values fo...
Ocular and periocular hemangiosarcoma in six horses. To determine the characteristics of and prognosis for ocular and periocular hemangiosarcoma in horses. Methods: Six horses treated for ocular or periocular hemangiosarcoma. Methods: A retrospective review of medical records from 2007 to 2015 was performed to identify horses with a histologic diagnosis of ocular or periocular hemangiosarcoma. Signalment (age, sex, breed), duration of clinical signs, prior treatment, tumor size and location, medical and surgical treatment including postoperative chemotherapy, follow-up time, and outcome were obtained from medical records. Histopathology was revi...
Retrospective evaluation of 155 adult equids and 21 foals with tetanus from Western, Northern, and Central Europe (2000-2014). Part 2: Prognostic assessment. To identify prognostic variables for adult equids and foals with tetanus. Methods: Multicenter retrospective study (2000-2014). Methods: Twenty Western, Northern, and Central European university teaching hospitals and private referral centers. Methods: One hundred fifty-five adult equids and 21 foals with tetanus. Methods: None. Results: Variables from history and clinical examination were statistically compared between survivors and nonsurvivors (adults: 49 survivors, 85 nonsurvivors; foals: 7 survivors, 10 nonsurvivors). Cases euthanized for financial reasons were excluded. Mortality rates i...
